Latest Ambulatory Surgery Center (ASC) Statistics

Key Ambulatory Surgery Center (ASC) Statistics

• Today's ASC marketplace represents a robust $45.6 billion industry in the United States.

• As of Q2 2025, there are 12,294 total ASCs operating nationwide, including 6,504 Medicare-certified facilities.

• Outpatient settings have become the dominant venue for surgical care, now hosting more than 80% of all U.S. surgeries.

• Procedure volumes at ASCs are forecast to climb 21% during the 2025–2035 window.

• By 2029, the ASC market is expected to reach $55.3 billion.

• Each year, ASCs collectively reduce Medicare expenditures by $2.3 billion.

• Patients who choose an ASC over a hospital outpatient department pocket an average of $684 in savings per procedure.

• America's aging population now includes more than 49 million individuals - representing 15% of citizens - who have reached age 65 or beyond.

Industry Size, History & Growth

Phoenix, Arizona became home to America's first freestanding ASC back in 1970, marking the birth of an industry that would transform outpatient care.

Hospital-owned facilities dominated the surgical landscape in 1981, handling a remarkable 93% of all procedures performed across the United States.

A pivotal moment came in 1995 when Medicare began reimbursing ASCs for 2,000 different procedures.

By 2005, the tide had shifted dramatically - hospital-owned facilities accounted for just 45% of outpatient surgeries nationwide.

The ASC sector has demonstrated consistent expansion in both facility count and economic impact:

• 2020: 5,927 Medicare-certified facilities generating $37.2 billion in market value

• 2021: 6,028 Medicare-certified facilities generating $40.8 billion in market value

• 2022: 6,087 Medicare-certified facilities generating $43.1 billion in market value

• 2023: 6,298 Medicare-certified facilities generating $43.1 billion in market value

• 2024: 6,394 Medicare-certified facilities generating $45.6 billion in market value

Today's ASC marketplace represents a robust $45.6 billion industry in the United States.

As of Q2 2025, the ASC landscape breaks down as follows:

• 12,294 total ASCs operating nationwide

• 6,504 facilities holding Medicare certification

• 5,790 facilities operating without Medicare certification

Across the country, ASCs maintain more than 18,000 operating rooms ready to serve patients.

The industry continues expanding at a steady 1.6% annual growth rate.

Throughout 2024, the Centers for Medicare & Medicaid welcomed 168 newly certified ASCs into the program.

Looking back to 2011, Medicare-certified ASC numbers have climbed by 20%.

Over the last decade alone, Medicare-certified facilities have surged by 25%.

Outpatient settings have become the dominant venue for surgical care, now hosting more than 80% of all U.S. surgeries.

The vast majority of ASCs - 95% - operate as for-profit enterprises.

Urban locations house 94% of all ASCs across the nation.

America's aging population now includes more than 49 million individuals - representing 15% of citizens - who have reached age 65 or beyond.

Demographics will continue shifting, with the 65-and-older population expected to comprise 24% of all Americans by 2060.

Procedure volumes at ASCs are forecast to climb 21% during the 2025–2035 window.

Market analysts anticipate 21% growth in ASC market value between 2024 and 2029.

By 2029, the ASC market is expected to reach $55.3 billion.

Geographic Distribution

When it comes to ASC density, Maryland leads the nation with 36 facilities per 100,000 Medicare Part B beneficiaries.

At the opposite end, Kentucky, West Virginia, and Vermont trail behind with 4 or fewer ASCs per 100,000 Medicare Part B beneficiaries.

These states boast the highest concentrations of Medicare-certified ASCs:

• California: 896 facilities

• Florida: 517 facilities

• Texas: 497 facilities

• Georgia: 423 facilities

• Maryland: 347 facilities

78Meanwhile, these regions have the most limited ASC presence:

• Vermont: 2 facilities

• District of Columbia: 2 facilities

• Guam: 2 facilities

• Virgin Islands: 4 facilities

• West Virginia: 7 facilities

Facility Characteristics & Ownership

Operating room capacity varies by facility type:

• Typical ASC: 2.89 ORs

• Single-specialty centers: 2.24 ORs

• Multi-specialty centers: 3.55 ORs

By 2029, OR counts are expected to rise:

• Average ASC: 3.01 ORs

• Single-specialty centers: 2.43 ORs

• Multi-specialty centers: 3.61 ORs

Facility size distribution based on operating room count:

• Small centers (1-2 ORs): 54%

• Medium centers (3-4 ORs): 31%

• Large centers (5-6 ORs): 10%

• Mega centers (7+ ORs): 5%

The split between facility types as of Q2 2025 reveals a near-even divide:

• Single-specialty ASCs: 51.2% (3,328 facilities)

• Multi-specialty ASCs: 48.8% (3,176 facilities)

Ownership models across the ASC landscape:

• Physicians as sole owners: 52%

• Physician-hospital joint ventures: 22%

• Physician-corporation partnerships: 13%

• Physician-hospital-corporation combinations: 3%

• Corporations alone: 3%

• Hospitals alone: 2%

• Alternative arrangements: 5%

A significant 63% of health system executives view outpatient surgery as a promising opportunity for joint venture partnerships.

Specialties & Procedures

On average, each ASC offers 2.84 different medical specialties.

Specialty offerings across all ASCs break down as follows:

• Other services (general surgery, cardiology, trauma, neurosurgery, vascular, urology, pediatrics): 37.3% (2,423 facilities)

• Orthopedic services: 36.4% (2,369 facilities)

• Pain management: 36.1% (2,349 facilities)

• Ophthalmology: 33.3% (2,163 facilities)

• Endoscopy: 31.9% (2,078 facilities)

• Plastic surgery: 27.3% (1,775 facilities)

• Podiatric care: 26.9% (1,750 facilities)

• ENT services: 22.4% (1,457 facilities)

• OBGYN: 17.7% (1,154 facilities)

• Dental procedures: 7.6% (494 facilities)

Among Medicare-certified ASCs, specialty prevalence looks like this:

• Pain management: 36% (2,229 facilities)

• Orthopedic: 36% (2,223 facilities)

• Ophthalmology: 34% (2,096 facilities)

• Endoscopy: 32% (1,982 facilities)

• Plastic surgery: 28% (1,722 facilities)

• Podiatry: 27% (1,659 facilities)

• Otolaryngology: 23% (1,416 facilities)

• Obstetrics/gynecology: 18% (1,106 facilities)

• Dental: 8% (472 facilities)

Single-specialty Medicare-certified ASCs focus on these areas:

• Endoscopy: 27% (862 facilities)

• Ophthalmology: 25% (797 facilities)

• Pain management: 13% (410 facilities)

• Plastic surgery: 6% (186 facilities)

• Orthopedics: 6% (182 facilities)

• Podiatry: 3% (91 facilities)

• Dental: 2% (54 facilities)

• Otolaryngology: 1% (39 facilities)

• Obstetrics/gynecology: 1% (33 facilities)

Multi-specialty Medicare-certified ASCs incorporate these services:

• Orthopedic: 36% (2,041 facilities)

• Pain management: 36% (1,819 facilities)

• Podiatry: 34% (1,568 facilities)

• Plastic surgery: 32% (1,536 facilities)

• Otolaryngology: 28% (1,377 facilities)

• Ophthalmology: 27% (1,299 facilities)

• Endoscopy: 23% (1,120 facilities)

• Obstetrics/gynecology: 18% (1,073 facilities)

• Dental: 8% (418 facilities)

ASCs organized by how many specialties they provide:

• Two specialties: 13.7%

• Three specialties: 7.9%

• Four specialties: 4.9%

• Five specialties: 4.6%

• Six specialties: 4.9%

• Seven specialties: 4.7%

• Eight specialties: 4.2%

• Nine specialties: 2.9%

Leading focus areas for single-specialty ASCs:

• Endoscopy: 26%

• Ophthalmology: 25%

• Other: 18%

Popular pairings at two-specialty ASCs:

• Orthopedic combined with pain management: 17%

• Endoscopy combined with other: 12%

• Ophthalmologic combined with plastic surgery: 10%

Favored combinations at three-specialty ASCs:

• Orthopedic, pain management, and podiatric: 20%

• Orthopedic, other, and pain management: 19%

During 2024, CMS gave the green light to 37 additional surgical procedures for ASC settings.

For 2025, CMS expanded the approved procedure list by another 21 surgeries.

Financial & Operational Performance

Essential financial benchmarks for ASCs (median figures):

• Total compensation (salaries, wages, benefits) relative to net revenue: 23%

• Salaries and wages relative to net revenue: 29.3%

• Benefits relative to total compensation: 15.0%

• Supplies relative to net revenue: 27.8%

• Cash reserves: 56 days on hand

• Collection timeline: 35-45 days in accounts receivable

• Aged receivables (over 90 days): under 15%

• Successfully processed claims: 98%

• Rejected claims: under 5%

Annual caseload per room varies by specialty (median figures):

• Gastroenterology: 1,500 cases

• Ophthalmology: 1,400 cases

• All procedures (per procedure room): 1,357 cases

• All surgical cases (per OR): 1,104 cases

• Orthopedic: 800 cases

Revenue generated per case differs across specialties:

• Orthopedics: $3,764 median (spanning $3,764–$6,419)

• Gynecology/OB-GYN: $2,933 median (spanning $2,365–$2,933)

• Podiatry: $2,688 median (spanning $2,688–$3,256)

• Otolaryngology: $2,543 median (spanning $2,543–$2,554)

• General surgery: $2,458 median (spanning $2,458–$2,835)

• Plastic surgery: $2,010 median (spanning $2,010–$4,594)

• Urology: $1,887 median (spanning $1,887–$2,483)

• Ophthalmology: $1,442 median (spanning $1,442–$1,634)

• Pain management: $968 median (spanning $968–$3,722)

• Gastroenterology: $800 median

Cost Savings & Healthcare Value

Procedure costs reveal a stark contrast between settings:

• Hospital outpatient departments: $7,716 average

• Ambulatory Surgery Centers: $3,157 average

Hospitals charge $3,077 more in facility fees than their ASC counterparts.

Patients who choose an ASC over a hospital outpatient department pocket an average of $684 in savings per procedure.

Each year, ASCs collectively reduce Medicare expenditures by $2.3 billion.

States delivering the greatest Medicare savings through ASCs:

• California: $636,721,133

• Florida: $449,728,622

• Texas: $392,596,117

• Maryland: $214,603,767

States with the most modest ASC-generated Medicare savings:

• Vermont: $3,505,222

• West Virginia: $4,385,873

• Maine: $9,593,767

• North Dakota: $13,279,175

CMS will boost ASC payments by 2.9% for covered procedures in 2025.

Conversely, physicians face a 2.9% reduction in their reimbursement rates for 2025.

SOURCES:

ASC Data

ASC Association

SIS First